VALIDATION OF THE COPD SEVERITY SCORE FOR ITS USE IN PRIMARY CARE. THE NEREA STUDY

¹ Servei de Pneumologia, Institut Clínic del Tòrax, (IDIBAPS), Ciber de Enfermedades Respiratorias (Ciberes), Hospital Clínic, Barcelona, Spain
² Primary Health Care Center "Jaume I", Societat Catalana de Medicina Familiar i Comunitària, Universitat Rovira i Virgili, Tarragona, Spain
³ Medical Director, R & D & I Unit, 3D Health Research, Barcelona Spain
⁴ Clinical Development & Medical Advice, J Uriach & Compañía S.A., Palau Solita Plegamans, Spain
⁵ Head of Project Management Dept, 3D Health Research, Barcelona Spain

^* To whom correspondence should be addressed. E-mail: marcm{at}clinic.ub.es.

	Abstract

Spirometry is underused for the assessment of severity of COPD in primary care (PC); therefore, simple assessment tools are required in this setting.

To validate the Chronic Obstructive Pulmonary Disease Severity Score (COPDSS) for use in PC.

Multicentre study in stable COPD patients in PC. Concurrent validity of the COPDSS was evaluated by examining the association between COPDSS, COPD clinical indicators and the London Chest Activity of Daily Living (LCADL), the European Quality of Life scale (EuroQol) questionnaires, and the Charlson comorbidity index.

837 patients with COPD were analysed (males 84.3%; mean age±SD: 68±11 years, FEV₁(%)=54.6±17.7%). We found a strong correlation between COPDSS and dyspnoea level (r=0.605) and a moderate correlation between COPDSS and exacerbation number (r=0.569). The COPDSS discriminated between patients with varying degrees of dyspnoea, (area under receiver operating characteristic (ROC) curve=0.837) and according to the number of exacerbations in the last year (AU ROC curve=0.773). Higher COPDS scores were significantly associated with lower EuroQol scores (r=-0.553), lower EuroQol VAS (r=-0.505) and higher LCADL scores (r=0.465).

These results indicate that the COPDSS is a useful and reliable tool to assess the severity of COPD in PC.